Advanced Clinical Associates, LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

HHA4479 Issued in AZ

Legal business name

ADVANCED CLINICAL ASSOCIATES, LLC

Practice address

10752 N 89TH PL
Suite 203
Scottsdale, AZ 85260-6730

Phone

(602) 373-0540

Fax

(480) 477-6571

NPI assigned

Nov 25, 2008

Last updated

Feb 23, 2016By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Kris Izdebski, RN BSN

Title

Managing Partner

Phone

(602) 373-0540

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1669627170. Details of each certification follow.

• CCN 037436 Home health agency · Active · Details

Home health agency certification: CCN 037436

Legal name

ADVANCED CLINICAL ASSOCIATES, LLC

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Apr 20, 2006

Last certification

Dec 6, 2019

Ownership / control type

Proprietary

Organization structure

LLCProprietary

Incorporated

May 7, 2007 in AZ

Enrollment address

10752 N 89TH PL
Ste 203
Scottsdale, AZ 85260-6732
HHA Branch

Listed as

Advanced Clinical AssociatesCCN 037436 · All quality measures

Overall star rating

1.5 of 5

Ownership

Proprietary

Certified

Apr 20, 2006

Medicare certification status

ActiveFrom the Provider of Services file

Services

Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

All disclosed owners & managing parties 1

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Aca Wellness Institute

  • Home Health Registered Nurse
  • Scottsdale, AZ
  • NPI 1861049967
  NPPES parent name

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1227571200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1456185600000",
    "number": "1669627170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10752 N 89TH PL",
            "address_2": "SUITE 203",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852606730",
            "telephone_number": "602-373-0540",
            "fax_number": "480-477-6571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10752 N 89TH PL",
            "address_2": "SUITE 203",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852606730",
            "telephone_number": "602-373-0540",
            "fax_number": "480-477-6571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED CLINICAL ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-25",
        "last_updated": "2016-02-23",
        "status": "A",
        "authorized_official_last_name": "IZDEBSKI",
        "authorized_official_first_name": "KRIS",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "602-373-0540",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RN BSN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "AZ",
            "license": "HHA4479",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Providers in Scottsdale, AZ by specialty
• Home Health Agency in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.